{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:33:06Z","timestamp":1778628786141,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T00:00:00Z","timestamp":1528848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Late after tetralogy of Fallot (<jats:styled-content style=\"fixed-case\">TOF<\/jats:styled-content>) repair some patients exhibit aortic dilatation and stiffness. Noninvasive assessment of aortic stiffness could contribute to understand this aortopathy and may be important in risk stratification for major aortic event.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included prospectively 82 adults after <jats:styled-content style=\"fixed-case\">TOF<\/jats:styled-content> repair and 41 age\u2010 and sex\u2010matched normal controls. Aortic diameters were measured by two\u2010dimensional transthoracic echocardiography and the aortic z\u2010score was estimated. Aortic deformation was assessed by M\u2010mode strain and global peak circumferential ascending aortic strain (<jats:styled-content style=\"fixed-case\">CAAS<\/jats:styled-content>), derived from two\u2010dimensional speckle tracking echocardiography (2D\u2010<jats:styled-content style=\"fixed-case\">STE<\/jats:styled-content>). Corrected <jats:styled-content style=\"fixed-case\">CAAS<\/jats:styled-content> was calculated as <jats:styled-content style=\"fixed-case\">CAAS<\/jats:styled-content>\/pulse pressure. Ascending aorta (<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>o) distensibility and stiffness index were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">TOF<\/jats:styled-content> patients (age 29.7\u00a0\u00b1\u00a08.4\u00a0years; follow\u2010up since <jats:styled-content style=\"fixed-case\">TOF<\/jats:styled-content> repair 23.0\u00a0\u00b1\u00a06.8\u00a0years) had smaller body surface area but a larger aorta compared to controls. <jats:styled-content style=\"fixed-case\">TOF<\/jats:styled-content> patients had lower <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>o distensibility (2.2 [0.0\u201321.0] vs 5.6 [0.0\u201312.5] cm<jats:sup>2<\/jats:sup>dyne<jats:sup>\u22121<\/jats:sup>10<jats:sup>\u22126<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01), higher aortic stiffness index (9.5 [2.7\u201398.4] vs 7.1 [2.3\u201320.4], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02) and lower <jats:styled-content style=\"fixed-case\">CAAS<\/jats:styled-content> (6.0\u00a0\u00b1\u00a03.9 vs 8.1\u00a0\u00b1\u00a04.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01) compared to controls. <jats:styled-content style=\"fixed-case\">CAAS<\/jats:styled-content> showed a better correlation with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>o z\u2010score (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u2212.25, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) compared to M\u2010mode strain. Systemic arterial compliance, arterial stiffness and corrected <jats:styled-content style=\"fixed-case\">CAAS<\/jats:styled-content> (\u03b2\u00a0=\u00a0\u22120.23, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02) were independently associated with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>o diameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">TOF<\/jats:styled-content> patients have a larger and stiffer <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>o compared to controls. <jats:styled-content style=\"fixed-case\">CAAS<\/jats:styled-content> derived from 2D\u2010<jats:styled-content style=\"fixed-case\">STE<\/jats:styled-content> allows a routine noninvasive method for assessing <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>o stiffness, with advantages over M\u2010mode strain, and may be used as predictor of major aortic or cardiovascular events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14046","type":"journal-article","created":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T04:22:21Z","timestamp":1528950141000},"page":"1362-1369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Ascending aorta in tetralogy of Fallot: Beyond echocardiographic dimensions"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7037-7557","authenticated-orcid":false,"given":"Cristina","family":"Cruz","sequence":"first","affiliation":[{"name":"Department of Cardiology Centro Hospitalar S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Faculty of Medicine University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Pinho","sequence":"additional","affiliation":[{"name":"Department of Cardiology Centro Hospitalar S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Faculty of Medicine 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